A new study shows that nearly one in five fifth-graders has received violent injuries, the majority from guns or knives — and bullies are most likely to be seriously injured.

For the study, researchers at The University of Texas Health Science Center at Houston (UTHealth) analyzed data from 4,300 children when they were in fifth, seventh, and 10th grades at public schools in and around cities in three U.S. communities: Houston, Los Angeles County, and Birmingham, Alabama.

The study found that the likelihood of injury increased as children became older, with one in three high school-age children sustaining a gunshot, stabbing wound, or assault-related injury needing medical attention.

According to the U.S. Centers for Disease Control and Prevention (CDC), which funded the research, bullying is common in high schools nationwide. These findings shed new light on the type of injuries occurring among children and who is most affected — bullies or victims of bullying.

“The biggest surprise was the sheer scale of intentional violent injuries children are suffering, even at elementary school age. It was also unexpected to discover how it’s not bullying victims, but bullies themselves who are most likely to get seriously hurt,” said first author Katelyn Jetelina, Ph.D., M.P.H., and an assistant professor at UTHealth School of Public Health in Dallas.

“This suggests the act of bullying may not necessarily be violent enough for victims to sustain serious injuries, and that bullies may be involved in other harmful behaviors.”

“It’s a first-of-its-kind look at how the injuries are sustained among school-age children and whether these are different for repeat bullying victims and repeat perpetrators,” she continued. “The interviews were conducted privately to improve reliability, but underreporting is still a potential issue, so the problem could be even worse.”

Data were obtained from Healthy Passages, a study of children and their primary caregivers followed from fifth through 10th grade between 2004 and 2011. That study’s principal investigators were Susan Tortolero Emery, Ph.D., of UTHealth School of Public Health; Susan Davies, Ph.D., of The University of Alabama at Birmingham Center for the Study of Community Health; and Mark Schuster, M.D., Ph.D., of Kaiser Permanente School of Medicine, who is also senior author of this study.

The study found that the volume and type of injury escalated in later years, especially among bullies.

On average, bullies were 41 percent more likely to be violently injured than other children, according to the study’s findings. By 10th grade, more than a quarter of their injuries were from firearms, the research showed.

“The evidence suggests perpetrators are engaging in various risky behaviors in addition to bullying,” Jetelina said. “This builds as they get older, which may indicate involvement in gangs, as well as drug and alcohol use.”

Boys were 22 percent more likely to sustain violent injury than girls, and black children were 30 percent more likely to experience injury than other race/ethnicity groups, according to the results of the study.

Children from lower-income families were also more vulnerable. Those whose parents were widowed had a 60 percent higher chance of reporting a violent injury, Jetelina noted.

“Injury is a leading cause of death for schoolchildren and this research reflects the epidemic. It also underlines the importance of early intervention and prevention strategies that target specific groups,” Jetelina said.

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Janice Wood

Janice Wood is a long-time writer and editor who began working at a daily newspaper before graduating from college. She has worked at a variety of newspapers, magazines and websites, covering everything from aviation to finance to healthcare.